Page 423 - Problem-Based Feline Medicine

20 – THE CAT WITH ENLARGED LYMPH NODES 415

Prognosis adenopathy. Unlike in other species, minimal sys-
temic signs have been noted.
Complete resolution reported for all cats.
Local edema for several weeks may occur post- Diagnosis
operatively.
Lymph node biopsy reveals lymphadenitis with or
without abscessation; chains of cocci are seen.
JUVENILE STREPTOCOCCAL
LYMPHADENITIS Biopsy of distant nodes reveals hyperplasia.

Culture of organism from lymph nodes, or skin (fasci-
Classical signs
itis) and tonsil (cervical lymphadenitis).
● Kittens.
● Fever. Differential diagnosis
● Cervical lymphadenopathy.
In the initial febrile phase, other infections could
mimic juvenile streptococcosis, and lymphadenitis
from other organisms could rarely occur. Acute
Pathogenesis FeLV/FIV infection can also cause fever and lymph-
adenopathy, although cats are not usually as ill and nor
Streptococcus canis (Group G β-hemolytic strepto-
is lymphadenopathy as prominent. Differentiation is on
cocci) may cause a variety of infections in cats including
the basis of lymph node culture and FeLV/FIV tests.
bacteremia, wound sepsis, pyoderma/cellulitis, pyo-
thorax, pneumonia, urogenital infections, arthritis, dis- Differential diagnoses for necrotizing fasciitis include
cospondylitis, acute neonatal death, and fading kittens. eosinophilic granuloma complex, other chronic bacter-
ial (e.g. nocardiosis) and fungal infections, panniculitis
In 3–7-month-old kittens, streptococcal lymphadeni-
and steatitis. Differentiation is based on cytology, his-
tis may occur.
tology and culture.
● The organism colonizes the tonsils (pharyngeal
trauma is not necessary) and then disseminates
along lymphatics to the lymph nodes of the head Treatment
and neck. Reported treatments include procaine penicillin
In mature cats necrotizing fasciitis has been reported. 50 000 IU SC once daily, or procaine and benzathine
The pathogenesis of increased streptococcal virulence penicillin 75 000–100 000 IU (combined dose) q 48–72
is not known. hours, or penicillin V 20 mg/kg PO q 8 h, for 5 days.
Penicillin G, ampicillin, amoxicillin and amocillin-
In dogs, the use of fluoquinolones has been incrimi- clavulanate should also be effective.
nated as a risk factor for streptococcal infections.
Lance and irrigate abscesses.
Clinical signs
Prognosis
Juvenile lymphadenitis is characterized by acute
Prognosis is excellent with early treatment.
fever, lethargy and inappetence.
● Marked unilateral or bilateral cervical lymph- Untreated cases of juvenile lymphadenitis may
adenopathy with or without generalized lymph- progress to pyothorax, pneumonia and acute death,
adenopathy occurs. likely due to streptococcal toxic shock syndrome.
● Single to multiple kittens in a litter may be
affected; they are usually litters from a young Transmission
queen.
Streptococci do not live in the environment; the source
Necrotizing fasciitis in mature cats is characterized by of infection is other cats harboring streptococci in a
multifocal ulcerative purulent skin lesions and lymph- carrier state.